Happy Thoughts

I haven't been feeling myself lately. I went back to work last week. I think it was time, as I was feeling well and starting to climb the walls a bit after four weeks on leave for recovery. The fastest way to get through to October is to keep myself busy, and they are being very gentle with me at the office, for which I am very grateful.

Nevertheless, I'm exhausted. Not sleeping well, emotionally stressed, physically drained...and all of this leads to annoying little kinks here or there. I feel like my body is betraying me a bit and I'm not used to this. We've always had an understanding. I offer up regular and vigorous exercise, copious amounts of fruits and veggies, a touch of chocolate, moisturizer and sunscreen, and the occassional spa treatment. In exchange, my body is strong and capable, it tolerates extremes, including the occassional binge party weekend or grueling hike above tree line in ski boots, and it never fails me. Now however, I know that this next and final phase of chemo is critical, but I'm worried that I'm not going into it as strong as I did the first two phases of treatment.

So, I'm doing what I can - trying to get to bed earlier, reserve my energy during this last week before chemo begins again, focus on the positive, center myself.

All that said, it seemed like a good time to count the many things that have made me happy lately...

• The roses are in full bloom in the front yard, and the backyard is perfumed with honeysuckle and bee's balm. A family of humming birds have taken up residence in the yard and appear each night at twilight to feed - if you sit still and quiet at the edge of the flower bed, you can get a good look and they'll occassionally buzz up to inspect you.
• The power went out last night due to an explosion at the local substation. Though Steve is a bit like a caged animal without TV or air conditioning (pacing, growling, swatting at imaginary bugs) it was a lovely evening - we three sat in the backyard eating melting ice cream for dinner, searching for roly-poly bugs and blowing bubbles. Then we read bedtime stories by flashlight. Maybe we'll pretend the power is out more often.
• Donovan had many firsts this last week. His first ice cream headache, his first time running through the sprinkler, and his first really successful trip to the potty - each priceless.
• When I started back at work last week, my team welcomed me with a new photo to hang in my office - a framed version of the view from Greg's bench, which I talked about in an earlier post. Though I generally believe there is no crying in business, I couldn't help tear up. The thought and effort that went into the gift was tremendous.
• When wandering around the yard or on his way upstairs, Van will often look up, reach out and say 'Hold my hand, Mama.' So powerful...
• My husband tells me each day that he loves me and thinks I'm beautiful. He is amazing.
• We saw Tom Petty and Joe Cocker last week at Red Rocks. An evening of classic tunes with good friends in a gorgeous outdoor setting is always good for the soul.

Karma

When I left the hospital they gave me a page of written discharge directions which instructed me to 'ambulate', so I've been making an effort to get out and walk regularly. I started with jaunts around the block, Van pushing his bubble lawnmower along beside me. I've been building up to longer, albeit slow walks a few miles across the park. These are usually followed by a nap, but I digress.

On the east side of the park, just below the Museum of Natural History, there's a fountain - around the fountain are a series of benches, one of which is dedicated to our friend Greg, who succumbed to colon cancer in February of 2009, after a truly valiant battle.

I've been finding myself drawn to the bench lately. About a mile and half from the house, it provides a perfect pit stop. And it boasts arguably the most stunning view in all of Denver. It overlooks the lake and pavilion on the west side of the park, backed up by the downtown skyline and beyond that, the Rocky Mountains, the peaks still frosted with the last of Spring snow. In the summertime, the fountain alongside will be surrounded by picnicking families, giggling children dashing through the water spouts.

Sitting around in the sunshine, there's a lot to think about. On my last visit, I mused a bit about karma. Greg's diagnosis had derailed what was a faint interest/belief in the idea. I certainly appreciate the Hindu concept of an immortal soul's journey to a higher spiritual existence, but I really didn't like the idea that his cancer in this lifetime was cultivated through some past life action. Oddly, I've been rethinking the concept lately and it doesn't bother me as much in the context of my own diagnosis. I'm actually OK with the idea that I might be paying off some grand debt to the universe. I feel like I'm generating good karma in this life, and if conquering cancer now makes me square for any past life transgressions, I think I should be solid as I approach the next spiritual plane. In the meantime, I'll do my best not to screw up this power position as I enjoy the next 50+ years of this lifetime...

Post Surgery Report

Surgery went very well - my doctor called it textbook perfect. My insides apparently look great post radiation, with considerably more healing and less scarring than expected. While the pathology report indicated nothing left of the tumor but a mere pin head sized spot, unfortunately there were also four positive lymph nodes so the cancer remains stage III. This stung. Although I understood that there would be no change in the post surgery chemo regimen regardless, knowing that the tumor had all but disappeared entirely I had convinced myself there would be downstaging - and all along we had thought there had been only one or two suspicious lymph nodes, so I hadn't prepared myself for the higher count. Ultimately though, its all gone and that's what counts.

Recovery from surgery itself hasn't been difficult. I was up and around the next morning, out of the hospital a day early and ditched the Vicodin within 36 hours of being home. Learning to live with my new Frankenstein abdomen however has been very difficult.

Because radiated tissue typically does not heal as quickly as normal tissue, the standard treatment in a case like mine is to create an ileostomy - similar to a colostomy but further up in the intestine, this bypasses the surgical site and allows it more time to heal. This is short term and will be reversed in about six months after chemo is over, but that hasn't made it any easier. Its changed what and how I eat, what I can wear, how I sleep. But this is all physical and easier to move past than the mental bruising. Learning to care for and live with this has raised more stress and anxiety in me than I have ever experienced - frankly more than I thought I was capable of.

Early on, outlining my course of treatment to Kristy, she quickly put it in perspective - 'Ok, so you'll poop into a bag for a few months, big deal - you'll watch Van grow up, graduate college, get married.' I think about this every day - I can live with this, to live for that.

Age is Not Just a Number

Van turns two tomorrow, and we had a party for him this weekend. I learned my lesson after last year, when I spent hours and hours making star-shaped melon skewers, potato salad, and blue cupcakes for nearly 40 people, and was then exhausted before the party even started - this year, another year wiser, I opted for a keg, pizza and bakery cake.

I am so very grateful that I was able to celebrate his birthday in these last few weeks pre-surgery. I know that next Monday is the start to several very challenging months for Steve, Van and me, and so this has been the perfect time for us to feast and be merry. Though hectic, it's been so much fun. Teaching him to sing happy birthday, helping him unwrap presents (each one gets a 'WHOAAA', even if it's socks), watching him load raisins from the new bulldozer into the dump truck while wearing his little hard hat...

Of course, there's a new level of emotion tied to birthdays for me too, because every year passed for all of us seems that much more precious. I used to say that age was a state of mind and the number didn't matter. I had started to joke the last year or two that I was going to pick an age and just stick with it - 31 sounded pretty good to me. I do still believe that age is a state of mind, because a lot depends on what you do with all of those years of experience - but the digits do matter. I will never again lie about my age. I will do my best to stay young at heart, but I will embrace the number, too. I will share it proudly, boast of it even. And someday when blowing out the candles on my 80th birthday cake, I will insist that there actually be 81 candles (one for good luck!) and it will be a beautiful sight.

Shrinking...Violets

During radiation treatment, I would lay on the table and try to find something positive to wrap my head around. Often I thought of the tumor dying and dissolving, and yes, sometimes I even imagined it squealing 'I'm melting, I'm melting...' Wicked Witch style as it went. I tried to picture healthy tissue springing forth and blooming in its place, like a beautiful garden. As far as actual probability, I was told that the tumor will go away only about 20% of the time, with another 20% experiencing no measurable change. The majority, about 60% of people, fall somewhere in the middle.

I visited with my surgeon end of last week, and although formal downstaging cannot be done until after surgery and pathology, the tumor is gone! This does not mean I'm cancer-free (yet), and both surgery and post-operative chemo are still necessary because treatment is based on the initial stage III diagnosis - but this simplifies surgery a bit and long term survival rates are positively impacted by significant downstaging.

I'm proceeding with cautious optimism until we do have pathology, but this is a great boost as we prepare for surgery on May 3rd!

The Breath of Spring

I must admit, updating when everything seems so status quo seems a bit odd, but this period of normalcy is so refreshing.

Keith, Kerry and Keira have come to visit for the week, and though I think we're all suprised that two small children can run four adults so ragged, it has been pure joy. Being only two months apart Van and Keira make perfect playpals - even when squabbling over whose turn it is with whatever the toy of the hour is, they're hilarious to watch. And when they're done fighting and they hug and kiss, it is precious.

They couldn't have come at a better time. I'm still very tired but all the burns and other discomforts are over with, and I feel mostly like I did before this all began - minus all the symptoms that suggested a problem in the first place. I've entertained guests on the back patio, cooked a few delicious meals, slid down the big slide at the park over and over, dyed eggs, and had an Easter morning egg hunt for half a dozen munchkins!

Surgery is scheduled six to eight weeks after radiation treatment is over, as it gives the radiation time to continue to work, but precedes any significant build up of scar tissue. My surgeon has tentatively scheduled surgery for May 3, although I'll see him in the coming week to firm that up. Though I dread they may tell me that Van will not be permitted to visit during my six day hospital stay, the May date will at least allow me to celebrate his second birthday at the end of the month! And the sooner surgery is behind me, the sooner the third phase of chemo can begin and the sooner we can all put this behind us and go on counting birthdays!

Today's Blog is Brought to You by the Number 6...

Phase I of treatment is a wrap - radiation finished up last Wednesday, and the chemo pump came off Monday. I wish I could tell you that the last few days treatment free have been blissful, but alas, no. As I had been told all along, despite the relief of being at the finish line, physically, the end is the worst. But, as I've also learned, treatment pushes you until you are teetering on the edge, and than its over and you recover - quickly.

Donovan has been learning to count - goldfish, stairs, the number of tires on the school buses we pass on our way to work. So lately I've been finding myself counting things, too.

Over 6 weeks of treatment I've had:

• 28 radiation treatments, with 3 shots of gamma rays each time
  
• 200 ml of Fluoroucil (chemo), pumped in slowly in tiny batches every 10 minutes, 6 times an hour, 144 times a day, for 28 days
  
• 6k ml of leucovorin, a reduced folic acid used in conjunction with the chemo to enhance effectiveness
  
• 9 prescriptions and 6 over the counter medications to address side effects
  
• 16 doctor appointments
  
• 6 blood tests
  
• 1 abdominal ultrasound
  
• 1 grey hair

Of course, there are also all the things I lost count of - the meals, cards and emails, and other thoughtful gestures from family and friends, the kisses and hugs from Van and Steve, the simple pleasures because I was finally too tired to over-complicate things.

So, now I have 6 glorious weeks off before phase II. Surgery and recovery will undoubtedly be a new challenge, but for now, I can just relax, heal, get back to running and skiing, and continue to count all the simple pleasures.